Hopkins' 'magic wand' reduces risk of brain surgery

October 04, 1990|By Sue Miller | Sue Miller,Evening Sun Staff

Researchers at the Johns Hopkins Medical Institutions have developed a computer-assisted "magic wand" they say will greatly reduce the risks of brain surgery.

The prototype device, tested and developed at Hopkins, "could revolutionize" neurosurgery, Dr. Donlin Long, the neurosurgeon in chief, said yesterday at a science writers' seminar called "Beyond Radiology: All Things Exposed."

So far, the wand has been tested on three brain tumor patients "with dramatic results," Long said. "We were able to reduce the size of incisions into the skull and brain and minimize potential brain damage."

Explaining how the system works, the researchers said a three-dimensional image of the patient's brain derived from CT scan data is fed into a television screen that the surgeon views during surgery.

During the operation, the image of the patient's brain is lined up with the patient's actual brain. Using the TV image, the surgeon makes precise cuts in the patient's skull. This precision keeps the opening to a minimum.

Once the brain is exposed, the surgeon places the robotic wand into cuts to the brain surface and moves it to outline the actual tumor to be removed.

Appearing much like a space-age robotic arm, the wand consists of a six-jointed mechanical sensor attached to a computer that processes radiologic image data.

"Currently, surgeons judge how large an opening to cut by sight alone and they tend to make very large incisions," Dr. James Zinreich, a radiologist, said. "Reducing the size of the incision will help decrease postoperative complications, including infection."

The computer, in use at Hopkins for three years, creates three-dimensional figures of a patient's skull and brain from data generated by standard X-ray computed tomography or magnetic resonance scans.

The computer is manufactured by ISG Technologies, a Toronto medical imaging company, and the robotic arm is made by FARO Medical Technologies of Orlando, Fla. The wand is patented by researchers at Hopkins, ISG and FARO and is expected to be on the market within a year.

In another development at yesterday's conference, researchers revealed they had successfully applied magnetic resonance imaging (MRI) to diagnose and evaluate acute strokes.

Dr. Nick Bryan, a radiologist and the principal investigator, said studies on baboons and humans have shown the MRI can diagnose a stroke on the first day it occurs and that brain tissue "does not die all of a sudden at the very beginning," he said. "There's time there for treatment, and that's something people didn't fully understand before."

Stroke, the third leading cause of death in the United States, is a progressive death of brain tissue most often due to loss of blood flow or bleeding in the brain. Presently there is no widely accepted "best" treatment for stroke.

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